2014 Utah Health Plan Quality of Care Report (HEDIS)

Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Altius

93.21%

Administrative

SelectHealth

93.22%

Administrative

NATIONAL AVERAGE:
93.40%

STATE AVERAGE:
93.21%

Adults' access to preventive/ambulatory services

Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Altius

96.74%

Administrative

SelectHealth

95.72%

Administrative

NATIONAL AVERAGE:
95.84%

STATE AVERAGE:
96.23%

Adults' access to preventive/ambulatory services

Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Altius

98.10%

Administrative

SelectHealth

97.67%

Administrative

NATIONAL AVERAGE:
97.27%

STATE AVERAGE:
97.88%

Children's Access To Primary Care Providers

Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Altius

85.56%

Administrative

SelectHealth

82.59%

Administrative

NATIONAL AVERAGE:
90.01%

STATE AVERAGE:
84.08%

Children's Access To Primary Care Providers

Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Altius

97.95%

Administrative

SelectHealth

98.42%

Administrative

NATIONAL AVERAGE:
97.94%

STATE AVERAGE:
98.18%

Children's Access To Primary Care Providers

Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Altius

84.61%

Administrative

SelectHealth

86.00%

Administrative

NATIONAL AVERAGE:
92.31%

STATE AVERAGE:
85.30%

Children's Access To Primary Care Providers

Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Altius

81.12%

Administrative

SelectHealth

79.95%

Administrative

NATIONAL AVERAGE:
92.93%

STATE AVERAGE:
80.53%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.

Health Plan

Rate

Data Collection Method

Altius

65.49%

Administrative

SelectHealth

73.56%

Admin+Chart Review

NATIONAL AVERAGE:
64.88%

STATE AVERAGE:
69.52%

Immunizations for Adolescents

Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.

Health Plan

Rate

Data Collection Method

Altius

89.71%

Administrative

SelectHealth

91.89%

Admin+Chart Review

NATIONAL AVERAGE:
78.17%

STATE AVERAGE:
90.80%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.

Health Plan

Rate

Data Collection Method

Altius

64.95%

Administrative

SelectHealth

72.89%

Admin+Chart Review

NATIONAL AVERAGE:
62.27%

STATE AVERAGE:
68.92%

Human Papillomavirus Vaccine for Female Adolescents

Percentage of female adolescents (13 years of age) who had three doses of the HPV vaccine by their 13th birthday

Health Plan

Rate

Data Collection Method

Altius

11.85%

Administrative

SelectHealth

15.82%

Admin+Chart Review

NATIONAL AVERAGE:
13.29%

STATE AVERAGE:
13.83%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.

Health Plan

Rate

Data Collection Method

Altius

59.69%

Admin+Chart Review

SelectHealth

66.23%

Admin+Chart Review

NATIONAL AVERAGE:
55.70%

STATE AVERAGE:
62.96%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.

Health Plan

Rate

Data Collection Method

Altius

92.65%

Admin+Chart Review

SelectHealth

92.70%

Admin+Chart Review

NATIONAL AVERAGE:
89.76%

STATE AVERAGE:
92.67%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Altius

51.67%

Admin+Chart Review

SelectHealth

55.66%

Admin+Chart Review

NATIONAL AVERAGE:
47.70%

STATE AVERAGE:
53.66%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.

Health Plan

Rate

Data Collection Method

Altius

81.51%

Admin+Chart Review

SelectHealth

81.75%

Admin+Chart Review

NATIONAL AVERAGE:
85.22%

STATE AVERAGE:
81.63%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control. (Lower Rate is Better)

Health Plan

Rate

Data Collection Method

Altius

27.62%

Admin+Chart Review

SelectHealth

22.45%

Admin+Chart Review

NATIONAL AVERAGE:
28.85%

STATE AVERAGE:
25.03%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg

Health Plan

Rate

Data Collection Method

Altius

73.05%

Admin+Chart Review

SelectHealth

76.28%

Admin+Chart Review

NATIONAL AVERAGE:
64.92%

STATE AVERAGE:
74.66%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.

Health Plan

Rate

Data Collection Method

Altius

84.86%

Admin+Chart Review

SelectHealth

87.22%

Admin+Chart Review

NATIONAL AVERAGE:
83.70%

STATE AVERAGE:
86.04%

Appropriate Testing for Children with Pharyngitis

Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Health Plan

Rate

Data Collection Method

Altius

83.30%

Administrative

SelectHealth

89.27%

Administrative

NATIONAL AVERAGE:
81.22%

STATE AVERAGE:
86.29%

Appropriate Treatment for Children with Upper Respiratory Infection

Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.

Health Plan

Rate

Data Collection Method

Altius

87.30%

Administrative

SelectHealth

89.41%

Administrative

NATIONAL AVERAGE:
84.23%

STATE AVERAGE:
88.35%

BMI Percentile for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had their BMI documented

Health Plan

Rate

Data Collection Method

Altius

39.65%

Admin+Chart Review

SelectHealth

78.34%

Admin+Chart Review

NATIONAL AVERAGE:
54.09%

STATE AVERAGE:
59.00%

Nutrition Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for nutrition

Health Plan

Rate

Data Collection Method

Altius

35.29%

Admin+Chart Review

SelectHealth

56.69%

Admin+Chart Review

NATIONAL AVERAGE:
56.48%

STATE AVERAGE:
45.98%

Physical Activity Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for physical activity

Health Plan

Rate

Data Collection Method

Altius

29.19%

Admin+Chart Review

SelectHealth

54.50%

Admin+Chart Review

NATIONAL AVERAGE:
53.16%

STATE AVERAGE:
41.84%

Adolescent Well-Care Visit

Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.

Health Plan

Rate

Data Collection Method

Altius

29.26%

Administrative

SelectHealth

34.02%

Administrative

NATIONAL AVERAGE:
44.76%

STATE AVERAGE:
31.64%

Well-child visits in the 3rd/4th/5th/& 6th yr of life

Percentage of children (3 - 6 years of age) who received one or more well-child visits.

Health Plan

Rate

Data Collection Method

Altius

56.77%

Administrative

SelectHealth

65.94%

Administrative

NATIONAL AVERAGE:
74.36%

STATE AVERAGE:
61.36%

Well-Child Visits In The First 15 Months of Life

Percentage of children (less than 15 months old) that received at least six or more well-child visits.

Health Plan

Rate

Data Collection Method

Altius

71.72%

Administrative

SelectHealth

79.56%

Administrative

NATIONAL AVERAGE:
78.67%

STATE AVERAGE:
75.64%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

70.96%

Admin+Chart Review

SelectHealth

81.56%

Admin+Chart Review

NATIONAL AVERAGE:
79.83%

STATE AVERAGE:
76.26%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

67.03%

Admin+Chart Review

SelectHealth

80.58%

Admin+Chart Review

NATIONAL AVERAGE:
77.05%

STATE AVERAGE:
73.81%

Childhood Immunization Status

Percentage of children that received four DTaP vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

75.76%

Admin+Chart Review

SelectHealth

86.00%

Admin+Chart Review

NATIONAL AVERAGE:
87.75%

STATE AVERAGE:
80.87%

Childhood Immunization Status

Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

85.37%

Admin+Chart Review

SelectHealth

92.63%

Admin+Chart Review

NATIONAL AVERAGE:
89.50%

STATE AVERAGE:
89.00%

Childhood Immunization Status

Percentage of children that received at least two HiB vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

86.90%

Admin+Chart Review

SelectHealth

92.86%

Admin+Chart Review

NATIONAL AVERAGE:
94.70%

STATE AVERAGE:
89.88%

Childhood Immunization Status

Percentage of children that received at least one MMR vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

88.21%

Admin+Chart Review

SelectHealth

91.65%

Admin+Chart Review

NATIONAL AVERAGE:
91.78%

STATE AVERAGE:
89.93%

Childhood Immunization Status

Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

75.98%

Admin+Chart Review

SelectHealth

89.19%

Admin+Chart Review

NATIONAL AVERAGE:
87.42%

STATE AVERAGE:
82.58%

Childhood Immunization Status

Percentage of children that received at least one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

87.77%

Admin+Chart Review

SelectHealth

91.15%

Admin+Chart Review

NATIONAL AVERAGE:
91.70%

STATE AVERAGE:
89.46%

Childhood Immunization Status

Percentage of children that received at least three IPV vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Altius

86.90%

Admin+Chart Review

SelectHealth

92.63%

Admin+Chart Review

NATIONAL AVERAGE:
93.14%

STATE AVERAGE:
89.76%

Colorectal Cancer Screening

Percentage of members (51 - 80 years of age) who had appropriate screening for colorectal cancer.

Health Plan

Rate

Data Collection Method

Altius

73.04%

Admin+Chart Review

SelectHealth

70.98%

Admin+Chart Review

NATIONAL AVERAGE:
62.63%

STATE AVERAGE:
72.00%

Use of Imaging Studies for Low Back Pain

Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.

Health Plan

Rate

Data Collection Method

Altius

78.28%

Administrative

SelectHealth

75.59%

Administrative

NATIONAL AVERAGE:
74.28%

STATE AVERAGE:
76.94%

Controlling High Blood Pressure

The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled (<140/90) during the measurement year.

Health Plan

Rate

Data Collection Method

Altius

67.34%

Admin+Chart Review

SelectHealth

71.94%

Admin+Chart Review

NATIONAL AVERAGE:
61.63%

STATE AVERAGE:
69.64%

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

The percentage of adults (12 - 64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription

Health Plan

Rate

Data Collection Method

Altius

72.90%

Administrative

SelectHealth

32.60%

Administrative

NATIONAL AVERAGE:
22.26%

STATE AVERAGE:
52.75%

Cholesterol Management for Patients With Cardiovascular Conditions

The percentage of members 18 to 75 with a cardiovascular condition and has manageable cholesterol.

Health Plan

Rate

Data Collection Method

Altius

58.75%

Admin+Chart Review

SelectHealth

68.19%

Admin+Chart Review

NATIONAL AVERAGE:
59.27%

STATE AVERAGE:
63.47%

Cholesterol Management for Patients With Cardiovascular Conditions

Percentage of members with cardiovascular conditions (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Altius

80.57%

Admin+Chart Review

SelectHealth

86.51%

Admin+Chart Review

NATIONAL AVERAGE:
88.13%

STATE AVERAGE:
83.55%

Adult BMI Assessment

The percentage of members (18 - 74 years of age) who had an outpatient visit and whose body mass index (BMI) was documented

Health Plan

Rate

Data Collection Method

Altius

82.66%

Admin+Chart Review

SelectHealth

90.00%

Admin+Chart Review

NATIONAL AVERAGE:
64.27%

STATE AVERAGE:
86.32%

Follow-Up After Hospitalization for Mental Illness

The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 30 days

Health Plan

Rate

Data Collection Method

Altius

64.53%

Administrative

SelectHealth

71.55%

Administrative

NATIONAL AVERAGE:
75.42%

STATE AVERAGE:
68.04%

Follow-Up After Hospitalization for Mental Illness

The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 7 days

Health Plan

Rate

Data Collection Method

Altius

45.60%

Administrative

SelectHealth

48.75%

Administrative

NATIONAL AVERAGE:
57.57%

STATE AVERAGE:
47.17%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Altius

97.06%

Administrative

SelectHealth

98.26%

Administrative

NATIONAL AVERAGE:
95.25%

STATE AVERAGE:
97.66%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Altius

93.82%

Administrative

SelectHealth

94.33%

Administrative

NATIONAL AVERAGE:
91.08%

STATE AVERAGE:
94.07%

Use of Appropriate Medications for People With Asthma

Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Altius

92.91%

Administrative

SelectHealth

94.79%

Administrative

NATIONAL AVERAGE:
92.11%

STATE AVERAGE:
93.85%

Persistence of Beta-Blocker Treatment After a Heart Attack

The percentage of members (18 years of age and older) who were hospitalized with a diagnosis of AMI and who received persistent beta-blocker treatment for 6 months after discharge

Health Plan

Rate

Data Collection Method

Altius

68.97%

Administrative

SelectHealth

80.00%

Administrative

NATIONAL AVERAGE:
83.03%

STATE AVERAGE:
74.48%

Asthma Medication Ratio

Percentage of members 5 to 64 year of age with persistent asthma and had a ratio of controller medications to total asthma medications of 50% of greater

Health Plan

Rate

Data Collection Method

Altius

82.58%

Administrative

SelectHealth

84.03%

Administrative

NATIONAL AVERAGE:
79.85%

STATE AVERAGE:
83.30%

Breast Cancer Screening

Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.

Health Plan

Rate

Data Collection Method

Altius

68.71%

Administrative

SelectHealth

70.00%

Administrative

NATIONAL AVERAGE:
69.86%

STATE AVERAGE:
69.36%

Cervical Cancer Screening

Percentage of women (21 - 64 years of age) who received one or more Pap tests to screen for cervical cancer.

Health Plan

Rate

Data Collection Method

Altius

69.32%

Administrative

SelectHealth

76.83%

Administrative

NATIONAL AVERAGE:
75.51%

STATE AVERAGE:
73.06%

Chlamydia Screening in Women

Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.

Health Plan

Rate

Data Collection Method

Altius

28.73%

Administrative

SelectHealth

28.86%

Administrative

NATIONAL AVERAGE:
45.16%

STATE AVERAGE:
28.79%

Prenatal and Postpartum care

Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.

Health Plan

Rate

Data Collection Method

Altius

76.73%

Admin+Chart Review

SelectHealth

87.50%

Admin+Chart Review

NATIONAL AVERAGE:
80.22%

STATE AVERAGE:
82.11%

Prenatal and Postpartum care

Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.

Health Plan

Rate

Data Collection Method

Altius

89.44%

Admin+Chart Review

SelectHealth

96.25%

Admin+Chart Review

NATIONAL AVERAGE:
89.70%

STATE AVERAGE:
92.85%

Medicaid Measures:

Adults' access to preventive/ambulatory services

Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Healthy U

81.38%

Administrative

Molina

83.14%

Administrative

SelectHealth

84.40%

Administrative

NATIONAL AVERAGE:
80.70%

STATE AVERAGE:
82.98%

Adults' access to preventive/ambulatory services

Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Healthy U

88.21%

Administrative

Molina

89.78%

Administrative

SelectHealth

89.73%

Administrative

NATIONAL AVERAGE:
87.31%

STATE AVERAGE:
89.23%

Adults' access to preventive/ambulatory services

Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Healthy U

87.87%

Administrative

Molina

90.16%

Administrative

SelectHealth

89.82%

Administrative

NATIONAL AVERAGE:
85.51%

STATE AVERAGE:
89.28%

Children's Access To Primary Care Providers

Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Healthy U

85.24%

Administrative

Molina

88.24%

Administrative

SelectHealth

89.88%

Administrative

NATIONAL AVERAGE:
88.52%

STATE AVERAGE:
87.79%

Children's Access To Primary Care Providers

Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Healthy U

97.11%

Administrative

Molina

96.39%

Administrative

SelectHealth

97.20%

Administrative

NATIONAL AVERAGE:
96.14%

STATE AVERAGE:
96.90%

Children's Access To Primary Care Providers

Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Healthy U

84.13%

Administrative

Molina

85.50%

Administrative

SelectHealth

86.01%

Administrative

NATIONAL AVERAGE:
88.25%

STATE AVERAGE:
85.21%

Children's Access To Primary Care Providers

Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Healthy U

87.16%

Administrative

Molina

88.07%

Administrative

SelectHealth

88.28%

Administrative

NATIONAL AVERAGE:
90.02%

STATE AVERAGE:
87.83%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.

Health Plan

Rate

Data Collection Method

Healthy U

67.94%

Administrative

Molina

66.41%

Admin+Chart Review

SelectHealth

76.11%

Admin+Chart Review

NATIONAL AVERAGE:
71.94%

STATE AVERAGE:
70.15%

Immunizations for Adolescents

Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.

Health Plan

Rate

Data Collection Method

Healthy U

71.66%

Administrative

Molina

84.09%

Admin+Chart Review

SelectHealth

92.04%

Admin+Chart Review

NATIONAL AVERAGE:
83.58%

STATE AVERAGE:
82.59%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.

Health Plan

Rate

Data Collection Method

Healthy U

63.65%

Administrative

Molina

65.13%

Admin+Chart Review

SelectHealth

75.48%

Admin+Chart Review

NATIONAL AVERAGE:
70.17%

STATE AVERAGE:
68.08%

Human Papillomavirus Vaccine for Female Adolescents

Percentage of female adolescents (13 years of age) who had three doses of the HPV vaccine by their 13th birthday

Health Plan

Rate

Data Collection Method

Healthy U

13.38%

Administrative

Molina

21.30%

Admin+Chart Review

SelectHealth

15.97%

Administrative

NATIONAL AVERAGE:
19.79%

STATE AVERAGE:
16.88%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.

Health Plan

Rate

Data Collection Method

Healthy U

44.23%

Admin+Chart Review

Molina

57.11%

Admin+Chart Review

SelectHealth

56.57%

Admin+Chart Review

NATIONAL AVERAGE:
53.53%

STATE AVERAGE:
52.63%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.

Health Plan

Rate

Data Collection Method

Healthy U

82.38%

Admin+Chart Review

Molina

82.75%

Admin+Chart Review

SelectHealth

93.97%

Admin+Chart Review

NATIONAL AVERAGE:
83.81%

STATE AVERAGE:
86.37%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Healthy U

2.94%

Administrative

Molina

41.26%

Admin+Chart Review

SelectHealth

48.54%

Admin+Chart Review

NATIONAL AVERAGE:
33.91%

STATE AVERAGE:
30.91%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.

Health Plan

Rate

Data Collection Method

Healthy U

54.99%

Administrative

Molina

71.09%

Admin+Chart Review

SelectHealth

74.45%

Admin+Chart Review

NATIONAL AVERAGE:
75.97%

STATE AVERAGE:
66.84%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control. (Lower Rate is Better)

Health Plan

Rate

Data Collection Method

Healthy U

46.58%

Admin+Chart Review

Molina

33.33%

Admin+Chart Review

SelectHealth

25.55%

Admin+Chart Review

NATIONAL AVERAGE:
45.57%

STATE AVERAGE:
35.15%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg

Health Plan

Rate

Data Collection Method

Healthy U

0.00%

Not Reportable

Molina

67.60%

Admin+Chart Review

SelectHealth

74.63%

Admin+Chart Review

NATIONAL AVERAGE:
60.49%

STATE AVERAGE:
47.41%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.

Health Plan

Rate

Data Collection Method

Healthy U

64.19%

Administrative

Molina

77.39%

Admin+Chart Review

SelectHealth

91.97%

Admin+Chart Review

NATIONAL AVERAGE:
79.02%

STATE AVERAGE:
77.84%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a blood glucose level less than 8%

Health Plan

Rate

Data Collection Method

Healthy U

45.60%

Admin+Chart Review

Molina

55.24%

Admin+Chart Review

SelectHealth

66.79%

Admin+Chart Review

NATIONAL AVERAGE:
45.52%

STATE AVERAGE:
55.87%

Appropriate Testing for Children with Pharyngitis

Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Health Plan

Rate

Data Collection Method

Healthy U

67.89%

Administrative

Molina

72.59%

Administrative

SelectHealth

89.27%

Administrative

NATIONAL AVERAGE:
66.52%

STATE AVERAGE:
76.58%

Appropriate Treatment for Children with Upper Respiratory Infection

Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.

Health Plan

Rate

Data Collection Method

Healthy U

94.42%

Administrative

Molina

92.07%

Administrative

SelectHealth

94.03%

Administrative

NATIONAL AVERAGE:
85.15%

STATE AVERAGE:
93.50%

Lead Screening in Children

Percentage of children (2 years of age) who had one or more test for lead poisoning by their 2nd birthday

Health Plan

Rate

Data Collection Method

Healthy U

30.40%

Administrative

Molina

24.54%

Admin+Chart Review

SelectHealth

19.53%

Admin+Chart Review

NATIONAL AVERAGE:
66.46%

STATE AVERAGE:
24.82%

BMI Percentile for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had their BMI documented

Health Plan

Rate

Data Collection Method

Healthy U

1.70%

Administrative

Molina

54.76%

Admin+Chart Review

SelectHealth

81.27%

Admin+Chart Review

NATIONAL AVERAGE:
56.92%

STATE AVERAGE:
45.91%

Nutrition Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for nutrition

Health Plan

Rate

Data Collection Method

Healthy U

1.22%

Administrative

Molina

43.85%

Admin+Chart Review

SelectHealth

60.10%

Admin+Chart Review

NATIONAL AVERAGE:
58.70%

STATE AVERAGE:
35.06%

Physical Activity Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for physical activity

Health Plan

Rate

Data Collection Method

Healthy U

0.00%

Administrative

Molina

29.93%

Admin+Chart Review

SelectHealth

53.04%

Admin+Chart Review

NATIONAL AVERAGE:
50.50%

STATE AVERAGE:
27.65%

Adolescent Well-Care Visit

Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.

Health Plan

Rate

Data Collection Method

Healthy U

41.36%

Administrative

Molina

41.90%

Admin+Chart Review

SelectHealth

41.85%

Admin+Chart Review

NATIONAL AVERAGE:
50.03%

STATE AVERAGE:
41.70%

Well-child visits in the 3rd/4th/5th/& 6th yr of life

Percentage of children (3 - 6 years of age) who received one or more well-child visits.

Health Plan

Rate

Data Collection Method

Healthy U

62.03%

Admin+Chart Review

Molina

60.89%

Admin+Chart Review

SelectHealth

63.74%

Admin+Chart Review

NATIONAL AVERAGE:
71.49%

STATE AVERAGE:
62.22%

Well-Child Visits In The First 15 Months of Life

Percentage of children (less than 15 months old) that received at least six or more well-child visits.

Health Plan

Rate

Data Collection Method

Healthy U

58.64%

Admin+Chart Review

Molina

54.70%

Admin+Chart Review

SelectHealth

73.91%

Admin+Chart Review

NATIONAL AVERAGE:
61.55%

STATE AVERAGE:
62.41%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

80.28%

Admin+Chart Review

Molina

78.23%

Admin+Chart Review

SelectHealth

79.16%

Admin+Chart Review

NATIONAL AVERAGE:
74.02%

STATE AVERAGE:
79.23%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

76.16%

Admin+Chart Review

Molina

75.22%

Admin+Chart Review

SelectHealth

76.55%

Admin+Chart Review

NATIONAL AVERAGE:
70.85%

STATE AVERAGE:
75.98%

Childhood Immunization Status

Percentage of children that received four DTaP vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

83.45%

Admin+Chart Review

Molina

81.25%

Admin+Chart Review

SelectHealth

82.55%

Admin+Chart Review

NATIONAL AVERAGE:
79.03%

STATE AVERAGE:
82.41%

Childhood Immunization Status

Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

91.97%

Admin+Chart Review

Molina

91.20%

Admin+Chart Review

SelectHealth

89.84%

Admin+Chart Review

NATIONAL AVERAGE:
88.57%

STATE AVERAGE:
91.00%

Childhood Immunization Status

Percentage of children that received at least two HiB vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

92.70%

Admin+Chart Review

Molina

91.44%

Admin+Chart Review

SelectHealth

89.05%

Admin+Chart Review

NATIONAL AVERAGE:
90.66%

STATE AVERAGE:
91.06%

Childhood Immunization Status

Percentage of children that received at least one MMR vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

92.94%

Admin+Chart Review

Molina

90.51%

Admin+Chart Review

SelectHealth

88.02%

Admin+Chart Review

NATIONAL AVERAGE:
90.54%

STATE AVERAGE:
90.49%

Childhood Immunization Status

Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

83.45%

Admin+Chart Review

Molina

82.18%

Admin+Chart Review

SelectHealth

82.55%

Admin+Chart Review

NATIONAL AVERAGE:
79.22%

STATE AVERAGE:
82.72%

Childhood Immunization Status

Percentage of children that received at least one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

92.94%

Admin+Chart Review

Molina

89.12%

Admin+Chart Review

SelectHealth

86.71%

Admin+Chart Review

NATIONAL AVERAGE:
90.19%

STATE AVERAGE:
89.59%

Childhood Immunization Status

Percentage of children that received at least three IPV vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Healthy U

93.43%

Admin+Chart Review

Molina

91.90%

Admin+Chart Review

SelectHealth

89.05%

Admin+Chart Review

NATIONAL AVERAGE:
90.04%

STATE AVERAGE:
91.46%

Use of Imaging Studies for Low Back Pain

Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.

Health Plan

Rate

Data Collection Method

Healthy U

71.72%

Administrative

Molina

76.85%

Administrative

SelectHealth

80.46%

Administrative

NATIONAL AVERAGE:
75.44%

STATE AVERAGE:
76.34%

Controlling High Blood Pressure

The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled (<140/90) during the measurement year.

Health Plan

Rate

Data Collection Method

Healthy U

58.39%

Admin+Chart Review

Molina

58.53%

Admin+Chart Review

SelectHealth

65.45%

Admin+Chart Review

NATIONAL AVERAGE:
56.51%

STATE AVERAGE:
60.79%

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

The percentage of adults (12 - 64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription

Health Plan

Rate

Data Collection Method

Healthy U

41.89%

Administrative

Molina

30.63%

Administrative

SelectHealth

53.95%

Administrative

NATIONAL AVERAGE:
26.55%

STATE AVERAGE:
42.15%

Cholesterol Management for Patients With Cardiovascular Conditions

The percentage of members 18 to 75 with a cardiovascular condition and has manageable cholesterol.

Health Plan

Rate

Data Collection Method

Healthy U

0.54%

Administrative

Molina

51.92%

Admin+Chart Review

SelectHealth

0.00%

Not Reportable

NATIONAL AVERAGE:
40.56%

STATE AVERAGE:
26.59%

Cholesterol Management for Patients With Cardiovascular Conditions

Percentage of members with cardiovascular conditions (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Healthy U

53.76%

Administrative

Molina

80.76%

Admin+Chart Review

SelectHealth

0.00%

Not Reportable

NATIONAL AVERAGE:
81.11%

STATE AVERAGE:
67.26%

Adult BMI Assessment

Percentage of members 18-74 years of age who had an outpatient visit and who had their body mass index documerted during the measurement year or the prior year.

Health Plan

Rate

Data Collection Method

Healthy U

15.85%

Administrative

Molina

86.96%

Admin+Chart Review

SelectHealth

94.65%

Admin+Chart Review

NATIONAL AVERAGE:
75.96%

STATE AVERAGE:
65.81%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Healthy U

88.68%

Administrative

Molina

91.90%

Administrative

SelectHealth

0.00%

Not Reportable

NATIONAL AVERAGE:
90.18%

STATE AVERAGE:
90.29%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

SelectHealth

94.12%

Administrative

NATIONAL AVERAGE:
84.07%

STATE AVERAGE:
86.65%

Use of Appropriate Medications for People With Asthma

Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Healthy U

81.94%

Administrative

Molina

89.83%

Administrative

SelectHealth

0.00%

Not Reportable

NATIONAL AVERAGE:
86.93%

STATE AVERAGE:
85.88%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 64 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Healthy U

79.71%

Administrative

Molina

86.14%

Administrative

NATIONAL AVERAGE:
84.07%

STATE AVERAGE:
86.65%

Asthma Medication Ratio

Percentage of members 5 to 64 year of age with persistent asthma and had a ratio of controller medications to total asthma medications of 50% of greater

Health Plan

Rate

Data Collection Method

Healthy U

61.90%

Administrative

Molina

67.86%

Administrative

SelectHealth

82.35%

Administrative

NATIONAL AVERAGE:
65.48%

STATE AVERAGE:
70.70%

Antidepressant Medication Management

Newly diagnosed and treated members who remained on an antidepressant medication for at least 12 weeks

Health Plan

Rate

Data Collection Method

Healthy U

39.36%

Administrative

Molina

44.08%

Administrative

SelectHealth

48.75%

Administrative

NATIONAL AVERAGE:
50.44%

STATE AVERAGE:
44.06%

Antidepressant Medication Management

Newly diagnosed and treated members who remained on an antidepressant medication for at least 6 months

Health Plan

Rate

Data Collection Method

Healthy U

23.88%

Administrative

Molina

59.20%

Administrative

SelectHealth

26.25%

Administrative

NATIONAL AVERAGE:
35.11%

STATE AVERAGE:
36.44%

Medication Management for People with Asthma

Percentage of members 5-64 years of age who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the measurement year.

Health Plan

Rate

Data Collection Method

Healthy U

33.64%

Administrative

Molina

32.18%

Administrative

SelectHealth

53.13%

Administrative

NATIONAL AVERAGE:
31.11%

STATE AVERAGE:
39.65%

Breast Cancer Screening

Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.

Health Plan

Rate

Data Collection Method

Healthy U

45.49%

Administrative

Molina

46.05%

Administrative

SelectHealth

0.00%

Not Reportable

NATIONAL AVERAGE:
57.88%

STATE AVERAGE:
45.77%

Chlamydia Screening in Women

Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.

Health Plan

Rate

Data Collection Method

Healthy U

24.81%

Administrative

Molina

37.41%

Administrative

SelectHealth

41.83%

Administrative

NATIONAL AVERAGE:
54.89%

STATE AVERAGE:
34.68%

Prenatal and Postpartum care

Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.

Health Plan

Rate

Data Collection Method

Healthy U

60.09%

Admin+Chart Review

Molina

69.62%

Admin+Chart Review

SelectHealth

75.42%

Admin+Chart Review

NATIONAL AVERAGE:
61.29%

STATE AVERAGE:
68.38%

Prenatal and Postpartum care

Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.

Health Plan

Rate

Data Collection Method

Healthy U

72.26%

Admin+Chart Review

Molina

82.37%

Admin+Chart Review

SelectHealth

88.81%

Admin+Chart Review

NATIONAL AVERAGE:
81.93%

STATE AVERAGE:
81.14%

Frequency of Ongoing Prenatal Care

Percentage of Medciaid deliveries that received 80% of the number of expected prenatal visits

Health Plan

Rate

Data Collection Method

Healthy U

56.93%

Admin+Chart Review

Molina

56.38%

Admin+Chart Review

SelectHealth

70.80%

Admin+Chart Review

NATIONAL AVERAGE:
55.64%

STATE AVERAGE:
61.37%

CHIP Measures:

Children's Access To Primary Care Providers

Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Molina

87.32%

Administrative

SelectHealth

88.04%

Administrative

NATIONAL AVERAGE:
88.52%

STATE AVERAGE:
87.68%

Children's Access To Primary Care Providers

Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Molina

98.89%

Administrative

SelectHealth

98.85%

Administrative

NATIONAL AVERAGE:
96.14%

STATE AVERAGE:
98.87%

Children's Access To Primary Care Providers

Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Molina

87.56%

Administrative

SelectHealth

86.14%

Administrative

NATIONAL AVERAGE:
88.25%

STATE AVERAGE:
86.85%

Children's Access To Primary Care Providers

Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Molina

88.06%

Administrative

SelectHealth

83.17%

Administrative

NATIONAL AVERAGE:
90.02%

STATE AVERAGE:
85.61%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.

Health Plan

Rate

Data Collection Method

Molina

68.72%

Admin+Chart Review

SelectHealth

71.11%

Admin+Chart Review

NATIONAL AVERAGE:
71.94%

STATE AVERAGE:
69.91%

Immunizations for Adolescents

Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.

Health Plan

Rate

Data Collection Method

Molina

87.94%

Admin+Chart Review

SelectHealth

91.94%

Admin+Chart Review

NATIONAL AVERAGE:
83.58%

STATE AVERAGE:
89.94%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.

Health Plan

Rate

Data Collection Method

Molina

67.95%

Admin+Chart Review

SelectHealth

70.00%

Admin+Chart Review

NATIONAL AVERAGE:
70.17%

STATE AVERAGE:
68.97%

Human Papillomavirus Vaccine for Female Adolescents

Percentage of female adolescents 13 years of age who had three does of the human papillomavirus (HPV) vaccine by their 13th birthday

Health Plan

Rate

Data Collection Method

Molina

20.80%

Admin+Chart Review

SelectHealth

19.71%

Admin+Chart Review

NATIONAL AVERAGE:
19.79%

STATE AVERAGE:
20.25%

Appropriate Testing for Children with Pharyngitis

Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Health Plan

Rate

Data Collection Method

Molina

71.15%

Administrative

SelectHealth

83.68%

Administrative

NATIONAL AVERAGE:
66.52%

STATE AVERAGE:
77.41%

Appropriate Treatment for Children with Upper Respiratory Infection

Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.

Health Plan

Rate

Data Collection Method

Molina

89.27%

Administrative

SelectHealth

87.52%

Administrative

NATIONAL AVERAGE:
85.15%

STATE AVERAGE:
88.40%

Lead Screening in Children

Percentage of members (2 years of age) who had one or more blood tests for lead poisoning by their second birthday.

Health Plan

Rate

Data Collection Method

Molina

19.53%

Admin+Chart Review

SelectHealth

16.48%

Administrative

NATIONAL AVERAGE:
66.46%

STATE AVERAGE:
18.00%

BMI Percentile for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had their BMI documented

Health Plan

Rate

Data Collection Method

Molina

48.84%

Admin+Chart Review

SelectHealth

78.53%

Admin+Chart Review

NATIONAL AVERAGE:
56.92%

STATE AVERAGE:
63.69%

Nutrition Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for nutrition

Health Plan

Rate

Data Collection Method

Molina

34.19%

Admin+Chart Review

SelectHealth

56.10%

Admin+Chart Review

NATIONAL AVERAGE:
58.70%

STATE AVERAGE:
45.14%

Physical Activity Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for physical activity

Health Plan

Rate

Data Collection Method

Molina

28.37%

Admin+Chart Review

SelectHealth

55.85%

Admin+Chart Review

NATIONAL AVERAGE:
50.50%

STATE AVERAGE:
42.11%

Adolescent Well-Care Visit

Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.

Health Plan

Rate

Data Collection Method

Molina

41.44%

Admin+Chart Review

SelectHealth

43.30%

Admin+Chart Review

NATIONAL AVERAGE:
50.03%

STATE AVERAGE:
42.37%

Well-child visits in the 3rd/4th/5th/& 6th yr of life

Percentage of children (3 - 6 years of age) who received one or more well-child visits.

Health Plan

Rate

Data Collection Method

Molina

59.28%

Admin+Chart Review

SelectHealth

63.78%

Admin+Chart Review

NATIONAL AVERAGE:
71.49%

STATE AVERAGE:
61.52%

Well-Child Visits In The First 15 Months of Life

Percentage of children (less than 15 months old) that received at least six or more well-child visits.

Health Plan

Rate

Data Collection Method

Molina

68.56%

Admin+Chart Review

SelectHealth

75.44%

Admin+Chart Review

NATIONAL AVERAGE:
61.55%

STATE AVERAGE:
72.00%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

86.98%

Admin+Chart Review

SelectHealth

84.67%

Admin+Chart Review

NATIONAL AVERAGE:
74.02%

STATE AVERAGE:
85.82%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

84.19%

Admin+Chart Review

SelectHealth

83.58%

Admin+Chart Review

NATIONAL AVERAGE:
70.85%

STATE AVERAGE:
83.88%

Childhood Immunization Status

Percentage of children that received four DTaP vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

91.16%

Admin+Chart Review

SelectHealth

89.04%

Admin+Chart Review

NATIONAL AVERAGE:
79.03%

STATE AVERAGE:
90.10%

Childhood Immunization Status

Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

95.35%

Admin+Chart Review

SelectHealth

92.70%

Admin+Chart Review

NATIONAL AVERAGE:
88.57%

STATE AVERAGE:
94.02%

Childhood Immunization Status

Percentage of children that received at least two HiB vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

94.88%

Admin+Chart Review

SelectHealth

93.43%

Admin+Chart Review

NATIONAL AVERAGE:
90.66%

STATE AVERAGE:
94.15%

Childhood Immunization Status

Percentage of children that received at least one MMR vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

96.74%

Admin+Chart Review

SelectHealth

91.61%

Admin+Chart Review

NATIONAL AVERAGE:
90.54%

STATE AVERAGE:
94.17%

Childhood Immunization Status

Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

90.70%

Admin+Chart Review

SelectHealth

90.51%

Admin+Chart Review

NATIONAL AVERAGE:
79.22%

STATE AVERAGE:
90.60%

Childhood Immunization Status

Percentage of children that received at least one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

96.74%

Admin+Chart Review

SelectHealth

91.24%

Admin+Chart Review

NATIONAL AVERAGE:
90.19%

STATE AVERAGE:
93.99%

Childhood Immunization Status

Percentage of children that received at least three IPV vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Molina

96.74%

Admin+Chart Review

SelectHealth

94.16%

Admin+Chart Review

NATIONAL AVERAGE:
90.04%

STATE AVERAGE:
95.45%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 11 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Molina

95.56%

Administrative

SelectHealth

95.56%

Administrative

NATIONAL AVERAGE:
90.18%

STATE AVERAGE:
95.56%

Use of Appropriate Medications for People With Asthma

Percentage of members (12 - 18 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Molina

89.74%

Administrative

SelectHealth

89.71%

Administrative

NATIONAL AVERAGE:
86.93%

STATE AVERAGE:
89.72%

Asthma Medication Ratio

Percentage of members 5-64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year.

Health Plan

Rate

Data Collection Method

Molina

67.86%

Administrative

SelectHealth

80.53%

Administrative

NATIONAL AVERAGE:
65.48%

STATE AVERAGE:
74.19%

Medication Management for People with Asthma

Percentage of members 12-18 years of age who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the measurement year.

Health Plan

Rate

Data Collection Method

Molina

20.00%

Administrative

SelectHealth

34.43%

Administrative

NATIONAL AVERAGE:
25.64%

STATE AVERAGE:
27.21%

Medication Management for People with Asthma

Percentage of members 5-11 years of age who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the measurement year.

Health Plan

Rate

Data Collection Method

Molina

34.88%

Administrative

SelectHealth

32.56%

Administrative

NATIONAL AVERAGE:
27.59%

STATE AVERAGE:
33.72%

Commercial PPO Measures:

Adults' access to preventive/ambulatory services

Percentage of members (20 - 44 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Humana

82.08%

Administrative

Regence

91.09%

Administrative

UnitedHealthCare

92.96%

Administrative

EMI Health

93.14%

Administrative

Aetna

93.97%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
92.49%

STATE AVERAGE:
90.65%

Adults' access to preventive/ambulatory services

Percentage of members (45 - 64 years of age) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Humana

86.30%

Administrative

Regence

94.85%

Administrative

UnitedHealthCare

95.73%

Administrative

EMI Health

95.81%

Administrative

Aetna

96.00%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
95.27%

STATE AVERAGE:
93.73%

Adults' access to preventive/ambulatory services

Percentage of members (65 years of age and older) that had an ambulatory or preventative care visit.

Health Plan

Rate

Data Collection Method

Humana

0.00%

Not Reported

Regence

97.36%

Administrative

UnitedHealthCare

95.94%

Administrative

EMI Health

97.83%

Administrative

Aetna

79.72%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
96.38%

STATE AVERAGE:
92.71%

Children's Access To Primary Care Providers

Percentage of children (12 - 19 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Humana

74.56%

Administrative

Regence

80.16%

Administrative

UnitedHealthCare

80.57%

Administrative

EMI Health

82.83%

Administrative

Aetna

83.48%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
87.58%

STATE AVERAGE:
80.31%

Children's Access To Primary Care Providers

Percentage of children (12 - 24 months of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Humana

95.23%

Administrative

Regence

96.29%

Administrative

UnitedHealthCare

96.67%

Administrative

EMI Health

96.12%

Administrative

Aetna

98.08%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
97.33%

STATE AVERAGE:
96.47%

Children's Access To Primary Care Providers

Percentage of children (25 months - 6 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Humana

75.88%

Administrative

Regence

83.18%

Administrative

UnitedHealthCare

82.38%

Administrative

EMI Health

82.18%

Administrative

Aetna

85.28%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
90.15%

STATE AVERAGE:
81.78%

Children's Access To Primary Care Providers

Percentage of children (7 - 11 years of age) who had a visit with a primary care practitioner.

Health Plan

Rate

Data Collection Method

Humana

68.95%

Administrative

Regence

78.43%

Administrative

UnitedHealthCare

78.86%

Administrative

EMI Health

76.80%

Administrative

Aetna

80.93%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
90.34%

STATE AVERAGE:
76.79%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine on or between the member's 11th and 13th birthday.

Health Plan

Rate

Data Collection Method

Humana

46.41%

Administrative

Regence

63.66%

Admin+Chart Review

UnitedHealthCare

61.30%

Administrative

EMI Health

49.13%

Administrative

Aetna

62.20%

Administrative

CIGNA

53.58%

Administrative

NATIONAL AVERAGE:
60.61%

STATE AVERAGE:
56.04%

Immunizations for Adolescents

Percentage of adolescents who received one TDAP vaccine between the member's 10th and 13th birthday.

Health Plan

Rate

Data Collection Method

Humana

65.12%

Administrative

Regence

83.40%

Admin+Chart Review

UnitedHealthCare

78.61%

Administrative

EMI Health

80.56%

Administrative

Aetna

77.40%

Administrative

CIGNA

71.53%

Administrative

NATIONAL AVERAGE:
72.87%

STATE AVERAGE:
76.09%

Immunizations for Adolescents

Percentage of adolescents who received one meningococcal vaccine, and one TDAP between the members 10th and 13th birthdays.

Health Plan

Rate

Data Collection Method

Humana

44.50%

Administrative

Regence

62.68%

Admin+Chart Review

UnitedHealthCare

59.75%

Administrative

EMI Health

47.74%

Administrative

Aetna

60.24%

Administrative

CIGNA

52.03%

Administrative

NATIONAL AVERAGE:
58.18%

STATE AVERAGE:
54.49%

Human Papillomavirus Vaccine for Female Adolescents

Percentage of female adolescents 13 years of age who had three does of the human papillomavirus (HPV) vaccine by their 13th birthday

Health Plan

Rate

Data Collection Method

Humana

5.45%

Administrative

Regence

12.20%

Administrative

UnitedHealthCare

8.72%

Administrative

EMI Health

8.36%

Administrative

Aetna

10.48%

Administrative

CIGNA

8.18%

Administrative

NATIONAL AVERAGE:
10.94%

STATE AVERAGE:
8.89%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had an eye exam.

Health Plan

Rate

Data Collection Method

Humana

33.08%

Admin+Chart Review

Regence

45.50%

Admin+Chart Review

UnitedHealthCare

45.18%

Admin+Chart Review

EMI Health

45.71%

Administrative

Aetna

32.28%

Not Reported

CIGNA

30.59%

Administrative

NATIONAL AVERAGE:
46.88%

STATE AVERAGE:
38.72%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their Hemoglobin A1c tested.

Health Plan

Rate

Data Collection Method

Humana

83.27%

Admin+Chart Review

Regence

84.90%

Admin+Chart Review

UnitedHealthCare

89.88%

Admin+Chart Review

EMI Health

85.72%

Administrative

Aetna

85.02%

Administrative

CIGNA

88.14%

Administrative

NATIONAL AVERAGE:
87.30%

STATE AVERAGE:
86.16%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Humana

34.59%

Admin+Chart Review

Regence

15.57%

Admin+Chart Review

UnitedHealthCare

40.94%

Admin+Chart Review

EMI Health

0.00%

Not Reported

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
50.24%

STATE AVERAGE:
30.37%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had their LDL-C screened.

Health Plan

Rate

Data Collection Method

Humana

74.90%

Admin+Chart Review

Regence

74.93%

Admin+Chart Review

UnitedHealthCare

76.70%

Admin+Chart Review

EMI Health

68.75%

Administrative

Aetna

72.62%

Administrative

CIGNA

73.67%

Administrative

NATIONAL AVERAGE:
81.31%

STATE AVERAGE:
73.59%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a blood pressure less than 140/90 Hg

Health Plan

Rate

Data Collection Method

Humana

33.08%

Admin+Chart Review

Regence

46.96%

Admin+Chart Review

UnitedHealthCare

59.53%

Admin+Chart Review

EMI Health

0.00%

Not Reported

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
58.48%

STATE AVERAGE:
46.52%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who had a test for diabetic nephropathy.

Health Plan

Rate

Data Collection Method

Humana

73.00%

Admin+Chart Review

Regence

75.67%

Admin+Chart Review

UnitedHealthCare

78.34%

Admin+Chart Review

EMI Health

79.10%

Administrative

Aetna

71.05%

Administrative

CIGNA

72.62%

Administrative

NATIONAL AVERAGE:
78.83%

STATE AVERAGE:
74.95%

Comprehensive Diabetes Care

Percentage of members with diabetes (18 - 75 years of age) who have poor HbA1c control (>9%). (Lower Rate is Better)

Health Plan

Rate

Data Collection Method

Humana

46.77%

Admin+Chart Review

Regence

55.96%

Admin+Chart Review

UnitedHealthCare

43.05%

Admin+Chart Review

EMI Health

0.00%

Not Reported

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
37.60%

STATE AVERAGE:
48.59%

Appropriate Testing for Children with Pharyngitis

Percentage of children (2 -18 years of age) who were diagnosed with pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode.

Health Plan

Rate

Data Collection Method

Humana

87.05%

Administrative

Regence

84.90%

Administrative

UnitedHealthCare

88.73%

Administrative

EMI Health

81.92%

Administrative

Aetna

90.81%

Administrative

CIGNA

87.07%

Administrative

NATIONAL AVERAGE:
78.45%

STATE AVERAGE:
86.75%

Appropriate Treatment for Children with Upper Respiratory Infection

Percentage of children (3 months - 18 years of age) who were given a diagnosis of upper respiratory infection and were not dispensed an antibiotic prescription.

Health Plan

Rate

Data Collection Method

Humana

89.15%

Administrative

Regence

85.47%

Administrative

UnitedHealthCare

88.61%

Administrative

EMI Health

85.18%

Administrative

Aetna

88.82%

Administrative

CIGNA

87.26%

Administrative

NATIONAL AVERAGE:
83.22%

STATE AVERAGE:
87.41%

BMI Percentile for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had their BMI documented

Health Plan

Rate

Data Collection Method

Humana

12.65%

Admin+Chart Review

Regence

37.47%

Admin+Chart Review

UnitedHealthCare

0.38%

Administrative

EMI Health

0.35%

Administrative

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
33.23%

STATE AVERAGE:
12.71%

Nutrition Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for nutrition

Health Plan

Rate

Data Collection Method

Humana

31.63%

Admin+Chart Review

Regence

37.47%

Admin+Chart Review

UnitedHealthCare

0.17%

Administrative

EMI Health

0.06%

Administrative

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
36.14%

STATE AVERAGE:
17.32%

Physical Activity Counseling for Children

The percentage of members (3 - 17 years of age) who had an outpatient visit and who had evidence of counseling for physical activity

Health Plan

Rate

Data Collection Method

Humana

18.25%

Admin+Chart Review

Regence

34.31%

Admin+Chart Review

UnitedHealthCare

0.06%

Administrative

EMI Health

0.00%

Administrative

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
33.80%

STATE AVERAGE:
13.15%

Adolescent Well-Care Visit

Percentage of members (12 - 21 years of age) who had at least one comprehensive well-care visit.

Health Plan

Rate

Data Collection Method

Humana

32.59%

Administrative

Regence

29.52%

Administrative

UnitedHealthCare

31.60%

Administrative

EMI Health

30.89%

Administrative

Aetna

32.44%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
40.64%

STATE AVERAGE:
31.40%

Well-child visits in the 3rd/4th/5th/& 6th yr of life

Percentage of children (3 - 6 years of age) who received one or more well-child visits.

Health Plan

Rate

Data Collection Method

Humana

55.23%

Administrative

Regence

58.66%

Administrative

UnitedHealthCare

58.50%

Administrative

EMI Health

59.44%

Administrative

Aetna

62.84%

Administrative

CIGNA

62.84%

Administrative

NATIONAL AVERAGE:
70.34%

STATE AVERAGE:
59.58%

Well-Child Visits In The First 15 Months of Life

Percentage of children (less than 15 months old) that received at least six or more well-child visits.

Health Plan

Rate

Data Collection Method

Humana

55.37%

Administrative

Regence

71.61%

Administrative

UnitedHealthCare

60.91%

Administrative

EMI Health

77.69%

Administrative

Aetna

74.67%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
76.95%

STATE AVERAGE:
68.05%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; and one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

65.94%

Admin+Chart Review

Regence

72.26%

Admin+Chart Review

UnitedHealthCare

67.75%

Admin+Chart Review

EMI Health

18.14%

Administrative

Aetna

22.59%

Administrative

CIGNA

14.55%

Administrative

NATIONAL AVERAGE:
67.49%

STATE AVERAGE:
43.54%

Childhood Immunization Status

Percentage of children that received four DTaP; three IPV; one MMR; two HiB; three hepatitis B; one VZV; and four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

63.02%

Admin+Chart Review

Regence

70.06%

Admin+Chart Review

UnitedHealthCare

0.00%

Not Reported

EMI Health

16.05%

Administrative

Aetna

0.00%

Not Reported

CIGNA

13.73%

Administrative

NATIONAL AVERAGE:
66.39%

STATE AVERAGE:
40.71%

Childhood Immunization Status

Percentage of children that received four DTaP vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

71.78%

Admin+Chart Review

Regence

81.02%

Admin+Chart Review

UnitedHealthCare

75.47%

Admin+Chart Review

EMI Health

63.26%

Administrative

Aetna

59.72%

Administrative

CIGNA

47.51%

Administrative

NATIONAL AVERAGE:
80.26%

STATE AVERAGE:
60.79%

Childhood Immunization Status

Percentage of children that received at least three hepatitis B vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

82.24%

Admin+Chart Review

Regence

81.27%

Admin+Chart Review

UnitedHealthCare

80.14%

Admin+Chart Review

EMI Health

23.02%

Administrative

Aetna

26.83%

Administrative

CIGNA

17.89%

Administrative

NATIONAL AVERAGE:
76.77%

STATE AVERAGE:
51.90%

Childhood Immunization Status

Percentage of children that received at least two HiB vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

82.97%

Admin+Chart Review

Regence

88.32%

Administrative

UnitedHealthCare

87.38%

Admin+Chart Review

EMI Health

76.28%

Administrative

Aetna

71.43%

Administrative

CIGNA

61.14%

Administrative

NATIONAL AVERAGE:
88.10%

STATE AVERAGE:
77.92%

Childhood Immunization Status

Percentage of children that received at least one MMR vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

85.40%

Admin+Chart Review

Regence

90.02%

Admin+Chart Review

UnitedHealthCare

88.08%

Admin+Chart Review

EMI Health

85.80%

Administrative

Aetna

85.70%

Administrative

CIGNA

84.44%

Administrative

NATIONAL AVERAGE:
88.66%

STATE AVERAGE:
86.57%

Childhood Immunization Status

Percentage of children that received at least four pneumococcal conjugate vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

72.98%

Admin+Chart Review

Regence

82.97%

Admin+Chart Review

UnitedHealthCare

0.00%

Not Reported

EMI Health

53.26%

Administrative

Aetna

60.55%

Administrative

CIGNA

48.52%

Administrative

NATIONAL AVERAGE:
78.31%

STATE AVERAGE:
63.65%

Childhood Immunization Status

Percentage of children that received at least one VZV vaccination on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

85.16%

Admin+Chart Review

Regence

89.04%

Admin+Chart Review

UnitedHealthCare

86.45%

Admin+Chart Review

EMI Health

84.65%

Administrative

Aetna

85.21%

Administrative

CIGNA

84.54%

Administrative

NATIONAL AVERAGE:
88.27%

STATE AVERAGE:
85.84%

Childhood Immunization Status

Percentage of children that received at least three IPV vaccinations on or before their second birthday.

Health Plan

Rate

Data Collection Method

Humana

81.02%

Admin+Chart Review

Regence

88.56%

Admin+Chart Review

UnitedHealthCare

86.68%

Admin+Chart Review

EMI Health

73.95%

Administrative

Aetna

67.28%

Administrative

CIGNA

55.04%

Administrative

NATIONAL AVERAGE:
86.19%

STATE AVERAGE:
75.42%

Colorectal Cancer Screening

Percentage of members (51 - 80 years of age) who had appropriate screening for colorectal cancer.

Health Plan

Rate

Data Collection Method

Humana

43.07%

Admin+Chart Review

Regence

61.30%

Admin+Chart Review

UnitedHealthCare

65.53%

Admin+Chart Review

EMI Health

37.36%

Administrative

Aetna

56.62%

Administrative

CIGNA

46.23%

Administrative

NATIONAL AVERAGE:
56.53%

STATE AVERAGE:
51.69%

Use of Imaging Studies for Low Back Pain

Percentage of members with a primary diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.

Health Plan

Rate

Data Collection Method

Humana

75.72%

Administrative

Regence

74.59%

Administrative

UnitedHealthCare

79.73%

Administrative

EMI Health

80.31%

Administrative

Aetna

81.62%

Administrative

CIGNA

78.08%

Administrative

NATIONAL AVERAGE:
74.45%

STATE AVERAGE:
78.34%

Controlling High Blood Pressure

The percentage of members 18 to 85 years of age who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled (<140/90) during the measurement year.

Health Plan

Rate

Data Collection Method

Humana

53.77%

Admin+Chart Review

Regence

35.77%

Admin+Chart Review

UnitedHealthCare

56.03%

Admin+Chart Review

EMI Health

0.00%

Not Reported

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
57.60%

STATE AVERAGE:
48.52%

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

Percentage of adults (18-64 years of age) with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription

Health Plan

Rate

Data Collection Method

Humana

28.88%

Administrative

Regence

23.68%

Administrative

UnitedHealthCare

27.92%

Administrative

EMI Health

24.45%

Administrative

Aetna

30.35%

Administrative

CIGNA

26.02%

Administrative

NATIONAL AVERAGE:
23.81%

STATE AVERAGE:
26.88%

Cholesterol Management for Patients With Cardiovascular Conditions

The percentage of members 18 to 75 with a cardiovascular condition and has manageable cholesterol.

Health Plan

Rate

Data Collection Method

Humana

28.26%

Admin+Chart Review

Regence

39.90%

Admin+Chart Review

UnitedHealthCare

53.65%

Admin+Chart Review

EMI Health

0.00%

Not Reported

Aetna

0.00%

Not Reported

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
50.24%

STATE AVERAGE:
40.60%

Cholesterol Management for Patients With Cardiovascular Conditions

Percentage of members with cardiovascular conditions (18 - 75 years of age) who had their LDL-C level under control.

Health Plan

Rate

Data Collection Method

Humana

67.39%

Admin+Chart Review

Regence

76.63%

Admin+Chart Review

UnitedHealthCare

80.46%

Admin+Chart Review

EMI Health

76.09%

Administrative

Aetna

75.00%

Administrative

CIGNA

72.65%

Administrative

NATIONAL AVERAGE:
82.59%

STATE AVERAGE:
74.70%

Adult BMI Assessment

Percentage of members 18-74 years of age who had an outpatient visit and who had their body mass index documerted during the measurement year or the prior year.

Health Plan

Rate

Data Collection Method

Humana

52.07%

Admin+Chart Review

Regence

64.72%

Admin+Chart Review

UnitedHealthCare

2.12%

Administrative

EMI Health

1.38%

Administrative

Aetna

7.44%

Administrative

CIGNA

0.00%

Not Reported

NATIONAL AVERAGE:
41.39%

STATE AVERAGE:
25.54%

Follow-Up After Hospitalization for Mental Illness

The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 30 days

Health Plan

Rate

Data Collection Method

Humana

34.15%

Administrative

Regence

60.33%

Administrative

UnitedHealthCare

66.03%

Administrative

EMI Health

58.97%

Administrative

Aetna

62.11%

Administrative

CIGNA

65.03%

Administrative

NATIONAL AVERAGE:
68.95%

STATE AVERAGE:
57.77%

Follow-Up After Hospitalization for Mental Illness

The percentage of members (6 years of age and older) who were hospitalized for treatment of selected mental health disorders and who had an follow-up visit within 7 days

Health Plan

Rate

Data Collection Method

Humana

29.27%

Administrative

Regence

41.60%

Administrative

UnitedHealthCare

46.60%

Administrative

EMI Health

34.61%

Administrative

Aetna

48.95%

Administrative

CIGNA

46.01%

Administrative

NATIONAL AVERAGE:
49.77%

STATE AVERAGE:
41.17%

Use of Appropriate Medications for People With Asthma

Percentage of members (5 - 50 years of age) during the measurement year who were identified as having persistent asthma and who were appropriately prescribed medication.

Health Plan

Rate

Data Collection Method

Humana

92.81%

Administrative

Regence

90.38%

Administrative

UnitedHealthCare

90.03%

Administrative

EMI Health

93.43%

Administrative

Aetna

93.79%

Administrative

CIGNA

91.03%

Administrative

NATIONAL AVERAGE:
90.52%

STATE AVERAGE:
91.91%

Asthma Medication Ratio

Percentage of members 5-64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater during the measurement year.

Health Plan

Rate

Data Collection Method

Humana

77.53%

Administrative

Regence

79.14%

Administrative

UnitedHealthCare

76.84%

Administrative

EMI Health

81.22%

Administrative

Aetna

76.24%

Administrative

CIGNA

80.60%

Administrative

NATIONAL AVERAGE:
78.36%

STATE AVERAGE:
78.59%

Antidepressant Medication Management

Newly diagnosed and treated members who remained on an antidepressant medication for at least 12 weeks

Health Plan

Rate

Data Collection Method

Humana

63.72%

Administrative

Regence

62.32%

Administrative

UnitedHealthCare

57.76%

Administrative

EMI Health

66.93%

Administrative

Aetna

71.58%

Administrative

CIGNA

46.84%

Administrative

NATIONAL AVERAGE:
64.26%

STATE AVERAGE:
61.52%

Antidepressant Medication Management

Newly diagnosed and treated members who remained on an antidepressant medication for at least 6 months

Health Plan

Rate

Data Collection Method

Humana

43.60%

Administrative

Regence

45.73%

Administrative

UnitedHealthCare

40.98%

Administrative

EMI Health

51.30%

Administrative

Aetna

62.98%

Administrative

CIGNA

26.58%

Administrative

NATIONAL AVERAGE:
48.70%

STATE AVERAGE:
45.19%

Medication Management for People with Asthma

Percentage of members 5-64 years of age who were identified as having persistent asthma and were dispensed appropriate medications that they remained on during the measurement year.

Health Plan

Rate

Data Collection Method

Humana

35.65%

Administrative

Regence

39.35%

Administrative

UnitedHealthCare

37.57%

Administrative

EMI Health

55.67%

Administrative

Aetna

65.89%

Administrative

CIGNA

45.07%

Administrative

NATIONAL AVERAGE:
49.64%

STATE AVERAGE:
46.53%

Breast Cancer Screening

Percentage of women (40 - 69 years of age) who had a mammogram to screen for breast cancer.

Health Plan

Rate

Data Collection Method

Humana

61.36%

Administrative

Regence

62.32%

Administrative

UnitedHealthCare

63.12%

Administrative

EMI Health

64.81%

Administrative

Aetna

61.79%

Administrative

CIGNA

65.01%

Administrative

NATIONAL AVERAGE:
69.48%

STATE AVERAGE:
63.06%

Chlamydia Screening in Women

Percentage of women (16 -24 years of age) who were identified as sexually active and who had at least one test for chlamydia during the measurement year.

Health Plan

Rate

Data Collection Method

Humana

23.82%

Administrative

Regence

26.93%

Administrative

UnitedHealthCare

31.70%

Administrative

EMI Health

23.10%

Administrative

Aetna

30.13%

Administrative

CIGNA

28.78%

Administrative

NATIONAL AVERAGE:
42.21%

STATE AVERAGE:
27.40%

Prenatal and Postpartum care

Percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.

Health Plan

Rate

Data Collection Method

Humana

65.69%

Admin+Chart Review

Regence

71.78%

Admin+Chart Review

UnitedHealthCare

73.93%

Admin+Chart Review

EMI Health

41.73%

Administrative

Aetna

43.71%

Administrative

CIGNA

50.07%

Administrative

NATIONAL AVERAGE:
70.88%

STATE AVERAGE:
57.82%

Prenatal and Postpartum care

Percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the organization.